How to Break Your Anxiety Habit | Judson Brewer

Mar 10, 2021 Episode Page ↗
Overview

Dr. Jud Brewer, a psychiatrist and deep dharma practitioner, discusses how anxiety is a habit that can be unwound using mindfulness. He explains how to map anxiety habit loops and use awareness to change one's relationship with anxious thoughts and feelings, especially during the pandemic.

At a Glance
16 Insights
1h 11m Duration
16 Topics
8 Concepts

Deep Dive Analysis

Introduction: COVID-19's Mental Health Impact and Guest Introduction

Defining Anxiety: Feelings vs. Worry as a Mental Behavior

Anxiety as a Habit Loop: Trigger, Behavior, and Perceived Reward

Why Worrying is Unhelpful and Impairs Cognitive Function

Differentiating Physical Anxiety Sensations from Worry-Driven Thoughts

Assessing Anxiety Severity: Clinical vs. Everyday Experience

Step 1: Mapping Out Anxiety and Worry Habit Loops

Step 2: Updating Reward Value Through Awareness and Disenchantment

Step 3: Finding a Bigger, Better Offer (BBO) for the Brain

The Superpower of Curiosity: Deprivation vs. Interest Curiosity

The Interplay of Love, Kindness, and Openness in Practice

Historical Context vs. In-the-Moment Awareness for Change

Formal vs. Informal Meditation Practices for Unwinding Anxiety

Debunking the Yerkes-Dodson Law: Anxiety and Performance

Clarifying Fear vs. Anxiety in the Face of Uncertainty

Summary of Dr. Jud Brewer's Resources

Anxiety (Dr. Brewer's Definition)

Anxiety is defined as both a physical feeling of nervousness or unease and as worry, which is a mental behavior. It's crucial to separate these two, as worry can be a behavior that drives and perpetuates anxiety habit loops.

Anxiety Habit Loop

This is a three-element process: a trigger (e.g., a negative emotion like fear), a behavior (e.g., worrying or avoiding), and a result/reward. The 'reward' for worrying can be a temporary distraction from more unpleasant feelings or a false sense of control, which paradoxically reinforces the anxiety.

Negative Reinforcement of Worry

Worry is negatively reinforced because it provides a temporary, albeit unhelpful, 'reward' by either distracting from the unpleasant feeling of fear or by giving a feeling of control. This reinforcement perpetuates the worry behavior, driving more anxiety.

Rescorla-Wagner Model (Reward Value)

This model describes how the brain stores and updates the reward value of behaviors. Awareness, through 'positive' or 'negative prediction errors' (when an outcome is better or worse than expected), is the only way to truly update these stored reward values and change habits.

Disenchantment

Rooted in ancient Buddhist psychology, disenchantment is the process of clearly seeing the unrewarding nature of old, unhelpful behaviors (like worrying or overeating). This clear seeing, facilitated by awareness, naturally leads the brain to drop those behaviors.

Deprivation Curiosity

This type of curiosity is driven by a lack of information, prompting the brain to seek answers. It often feels 'closed down' or like a rabbit hole, as the goal is to reach a destination of knowing.

Interest Curiosity

This form of curiosity focuses on the joy of discovery and exploring the journey itself, rather than needing a specific answer. It feels 'opened up' and is inherently more rewarding than deprivation curiosity.

Flow State

A state of optimal performance where an individual is completely absorbed in an activity, experiencing effortlessness, selflessness, and a merging of action and outcome. It is characterized by a complete absence of worries or anxiety.

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How does Dr. Jud Brewer define anxiety?

Dr. Brewer defines anxiety as both a physical feeling of nervousness or unease and as worry, which is a mental behavior. He emphasizes the importance of teasing these two aspects apart to understand how anxiety habit loops are formed.

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Why is it important to differentiate between the feeling of anxiety and the act of worrying?

Differentiating is crucial because physical feelings are just sensations, while worry is a mental behavior that can drive more worry. Worry can be negatively reinforced by distracting from fear or giving a false sense of control, perpetuating the anxiety habit loop.

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How does worry contribute to anxiety?

Worry contributes to anxiety by creating a habit loop where anxiety triggers worry, and worry provides a temporary 'reward' (like distraction or a feeling of control), which then reinforces more worrying. This process can make anxiety worse and hinder the brain's ability to think and plan effectively.

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How can someone determine if their anxiety is clinical or 'garden variety'?

The distinction is largely subjective, but a key indicator is whether the anxiety is causing a significant disturbance in one's life or ability to function. Clinical tools like the GAD-7 questionnaire can also provide a marker of severity.

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Is formal meditation practice required to unwind anxiety?

No, formal meditation practice is not strictly required. Dr. Brewer's research suggests that informal mindfulness practices, such as short moments of awareness applied many times throughout the day in everyday contexts, are highly effective, especially for those just starting.

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Is any level of anxiety healthy or beneficial for performance?

According to Dr. Brewer, based on a review of research, there is no evidence to suggest that anxiety actually helps performance. The idea of a 'sweet spot' for anxiety (the Yerkes-Dodson Law) is largely a myth, with data indicating that more anxiety generally leads to worse performance.

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What is the difference between fear and anxiety?

Fear is typically a short-term, reflexive, and evolutionarily adaptive response to an immediate threat, often peaking and then subsiding quickly. Anxiety, in contrast, is often a chronic, optional response characterized by uncontrolled worry, particularly in the face of uncertainty, and can be detrimental to well-being.

1. Map Anxiety Habit Loops

Identify and understand your anxiety and worry-related habit loops, including other related unhelpful habits (e.g., overeating, excessive social media), using a simple ’trigger, behavior, result’ framework. This helps to see how anxiety perpetuates itself.

2. Update Worry’s Reward Value

When you find yourself worrying, bring awareness to the present moment by asking: ‘What am I getting from this right now?’ (e.g., increased anxiety) and ‘Is this actually solving the problem?’ This helps your brain recognize the true unrewarding nature of worry.

3. Embrace Curiosity as BBO

Replace unrewarding anxiety and worry with curiosity, asking yourself what feels better: being anxious or being curious about that anxiety. Curiosity is an intrinsic, intrinsically rewarding ‘bigger, better offer’ that helps you step out of old habit loops.

4. Accept & Welcome Anxiety

Instead of resisting, trying to fix, or avoiding anxiety, practice simply being with and accepting the feelings as body sensations. This stops feeding the anxiety and allows for a shift in your relationship to it, as ‘what we resist persists’.

5. Practice Informal Mindfulness

Engage in ‘short moments many times’ of informal mindfulness throughout your day, such as mindfully eating, smoking, or simply noting anxiety sensations or taking a mindful breath. This helps establish the habit of awareness in context before formal meditation.

6. Differentiate Fear from Worry

Recognize that physical feelings of fear can be useful signals, but obsessive thinking (worry) triggered by fear is unhelpful and makes things worse by hindering clear thought and planning. Watch out for the latter.

7. Cultivate Interest Curiosity

Focus on ‘interest curiosity’ – the joy of discovery and exploring the journey – rather than ‘deprivation curiosity,’ which is about seeking to fill an information gap. Interest curiosity feels more open and rewarding.

8. Practice Brain Self-Compassion

When anxious, practice self-compassion by reminding yourself, ‘Oh, that’s how my brain works,’ recognizing that your brain is trying to protect you, even if it’s overreacting to non-threats. This helps to give your brain a break and break the cycle of self-judgment.

9. Focus on Present ‘What’

When dealing with unhelpful patterns, devote your energy to ‘what is happening right now’ rather than dwelling on ‘why’ it’s happening. Understanding the present pattern is more effective for changing habits than focusing on past origins.

10. Embrace Growth Zone Discomfort

When stepping out of your comfort zone into new, uncomfortable territory, recognize that this discomfort is a natural brain survival mechanism. Approach it with curiosity rather than panic to avoid reverting to old, unhelpful patterns.

11. Play the Tape Forward

To overcome unhelpful habits (e.g., drinking), practice ‘playing the tape forward’ by reflecting on past negative outcomes of the habit and comparing them to the present positive experience of not engaging in it. This helps update the brain’s reward value.

12. Use GAD-7 for Severity

Utilize the GAD-7 (Generalized Anxiety Disorder 7) questionnaire, a common clinical tool, to gauge the severity of your anxiety, with scores indicating minimal (<5), mild (5-10), moderate (10-15), or severe (>15) anxiety.

13. Assess Life Disturbance

To determine if your anxiety is problematic, ask yourself if it is causing a disturbance in your life or disrupting your ability to function fully, rather than solely relying on symptom checklists.

14. Take Deep Breaths

When feeling worried, consciously take deep breaths, as this simple practice is phenomenally helpful in managing the physical sensations of worry and anxiety.

15. Avoid Unhelpful Compensatory Habits

Refrain from employing unhelpful compensatory mechanisms like excessive drinking, overeating, or social media addiction for news, as these habits solidify anxiety rather than addressing its root cause.

16. Cultivate Love and Kindness

Cultivate feelings of love and kindness, as they share the same core quality of ‘opening up’ and expansion as curiosity, helping you see the unrewarding nature of contraction and fostering connection.

Anxiety is a habit, one that you can unwind.

Dr. Jud Brewer

Worrying not only is not helpful, but it actually makes things worse because we can't think and plan.

Dr. Jud Brewer

It's not about not having thoughts or emotions or sensations. It's about changing our relationship to them.

Dr. Jud Brewer

What we resist persists.

Dr. Jud Brewer

Our thinking brain doesn't hold a candle to our feeling body.

Dr. Jud Brewer

Curiosity feels better.

Dr. Jud Brewer

Forgiveness is giving up hope of a better past.

Dr. Jud Brewer

Can we be comfortable with the discomfort?

Dr. Jud Brewer

Dr. Jud Brewer's 3-Step Method for Unwinding Anxiety

Dr. Jud Brewer
  1. Map out anxiety and worry habit loops: Identify the trigger (e.g., a feeling of anxiety), the behavior (e.g., worrying or avoiding), and the perceived result/reward (e.g., temporary distraction or feeling of control). This can also be applied to other related unhelpful habits like overeating or excessive social media use.
  2. Update the reward value of worrying: When you notice yourself worrying, ask 'What am I getting from this right now?' and 'Is this actually solving the problem I hope it will solve?' Also, observe if you are resisting anxiety and what you gain from that resistance. This process helps your brain see the true unrewarding nature of the behavior.
  3. Find a Bigger, Better Offer (BBO): Once the brain recognizes an old behavior as unrewarding, it seeks something better. Replace unhelpful behaviors with intrinsically rewarding ones like curiosity, kindness, or connection. When feeling anxiety, cultivate 'interest curiosity' by gently exploring the physical sensations without diving into a narrative about why you're anxious.
tripled
Anxiety rates increase Between 2019 and 2020, during the COVID-19 pandemic.
5.15
Number Needed to Treat (medications for anxiety) Meaning 5.15 people must be treated for one to show significant reduction in symptoms.
50%
Hit rate for Cognitive Behavioral Therapy (CBT) Percentage of patients who respond to treatment for anxiety.
1.6
Number Needed to Treat (Unwinding Anxiety app) Meaning 1.6 people must use the app for one to show significant reduction in symptoms.
below 5
GAD-7 score for minimal anxiety On the Generalized Anxiety Disorder 7 questionnaire.
5 to 10
GAD-7 score for mild anxiety On the Generalized Anxiety Disorder 7 questionnaire.
10 to 15
GAD-7 score for moderate anxiety On the Generalized Anxiety Disorder 7 questionnaire.
above 15
GAD-7 score for severe anxiety On the Generalized Anxiety Disorder 7 questionnaire.
4%
Studies supporting Yerkes-Dodson inverted U-shaped curve Out of studies reviewed regarding the relationship between anxiety/arousal and performance.
46%
Studies supporting inverse relationship (more anxiety, worse performance) Out of studies reviewed regarding the relationship between anxiety/arousal and performance.